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    Steroid Injections
    Pretzelady posted:
    Do any of you with RA take steroid injections? If so, how often and how many (say over the course of a year)?

    Wondering if there's an easier way to manage my pain. I am currently taking Metx (meth-ro-tex-ate), not sure of spelling...

    Look forward to hearing your feedback!
    RAWarrior responded:
    Hi Pretzel. That's cute.

    Some docs do these every few months. Others not at all. They can help symptoms subside - until the steroid wears off. In some patients the effect lasts weeks; in others only days.

    They can be into and individual joint or a larger systemic dose into the hip. Does your doc suggest you should get one?

    Pain management is important, but it's second to disease management. The hope is to get the disease controlled to the point that less pain management is needed.

    Has the mtx helped you? How long have you taken it?

    I hope this helps. Good luck.
    Kelly :D
    Pretzelady replied to RAWarrior's response:
    I have been on metx for 10 years with no problems at all except some hairloss. I take ibuprofen for pain, sometimes 4 at a time. My joints aren't turning much but lately the flares have been lasting longer. My rheumy gives me two to three shots at a time for pain and it really helps, but I feel it is a quick fix till the next time. I have been taking the shots for years in the joints that are hurting at the time. I am starting to be a wimp and do not want shots any more. He mentioned going on Humira to me. I really don't know what to do. All the side effects are scary. I have to do something as this last flareup I had lasted 6 weeks and I could hardly do my everyday chores and personal things. He put me on steroids for the week and I go back when they are finished. He wants to do bloodwork and discuss the Humira. sometimes I get shots about every 2 months. I have had them everywhere except in the hip. Thank you for your reply.
    RAWarrior replied to Pretzelady's response:
    Now I see why you are worried about how many you can get! It would be safer in my opinion to take Humira than get so many shots. Thats my opinion, but I think it's pretty well supported. My experience with that med: I was on Humira for 2 1/2 yrs w/no side effects. Steroid side effects are risky too. I have written some articles about Biologics on my blog if that helps. Here is a link to one about making those tough medicine decisions - link. It's about long term damage too. I'm pretty sure that the shots only treat the symptoms. They don't help prevent permanent damage of RA.

    good luck to you,
    Kelly :D
    iamabrit50 replied to Pretzelady's response:
    i take humira every week you self inject i also take steroids and methotrexate i find i am still tired but not as much as i used to be i also take vicodin for the pain i recommend you try it and if your insurance doesnt cover them humira will help you
    annplato replied to RAWarrior's response:
    In RA, as I understand it nothing stops joint degeneration and mtx is only slowing it down.

    I've dealt with anemia practically all my life (only since menopause am I no longer anemic) and what I feared the most about mtx was the reduction of RBC.

    RA in itself is fatiguing, I didn't want to have to cope with the anemia induced feelings of weakness and somnolence once again.

    For acute inflammatory pain I use an herbal ointment: beeswax based birthwort extract. It is still used in Romania, and I was treated with birthwort soaked leaves when I was 5 years old and had, what was diagnosed at the time as rheumatoid fever.
    annplato responded:
    I refused to take methatrexate and am on 5mg. prednisone pill a day and that keeps me on an even keel with my recently diagnosed RA (4months ago).

    My rheumatologist was adamant about my taking steroids for the "side-effects", but when I compared the mathatrexate side effects (wakening the immune response of the body permanently) with steroids (weakening the immune system but reversible by discontinuing it!) I asked my primary care physician to prescribe me these low dose steroid pills. My rheumatologist is pleased with my coping with my RA as of now, but the "strange" fact of my RA is that I have no joint degeneration what-so-eve as of now.

    I don't know about the injected form of steroids, but I am pleased with my assessment of my condition and my decision as to what works best for me.

    I don't have to take either analgesics or NSAIDs for now, and like all RA sufferers I have my better days and not so good days.
    judylscott replied to Pretzelady's response:
    I have only had RA for 16 months, but here is my experience:
    My Dr. first had me take Prednisone to control my pain, which was in all joints possible, and I could only shuffle
    when I tried to walk. After a month (I think) he added Methotrexate to the Prednisone. It seemed to me that the Methotrexate made no improvement in my symptoms. After a month or two of Prednisone and Methotrexate, he added Humira. It took three months on the Humira before I felt better and I was then able to stop taking the Prednisone, which made my Dr. happy! My symptoms were under control for three months and then the pain started breaking through again. My Dr. said we could try something different and I asked him about Arava, a drug two friends are taking. He said "OK". I quit the Methotrexate and have been on Humira and Arava for about three months. I have been feeling much better and am getting stronger. I have been working with a personal trainer and the exercises she has me do help tremendously. I lost 30 pounds in the first months I had this disease, so I lost some muscle and was also diagnosed with osteopenia a year ago. The exercises I do are for increasing strength: free weights, weight machines, situps,
    and exercise ball. I also walk with my dogs, go to a senior
    citizen exercise class and a belly dance class (which is really fun!). If I don't exercise, I start experiencing pain in my wrists, shoulders, feet or elbows. I am going for another Dexa Scan in a couple of weeks and will be eager to see if
    my bones have improved any. I wish you all the best in your battle with RA. My advice would be: don't be afaid to try different drugs and try to get off the Prednisone.
    RAnewbie responded:
    Hi PL, I get injections almost every 2-3 weeks depending on how much pain I can take. If it gets unbearable, 2 weeks. I haven't yet found the right drug combination. I tried MTX and Enbrel (very expensive) and has so much fatigue I slept all the time. The Rheum took me off of it and I am on Arava now. So far it has lessened my pain.

    I was diagnosed only 6 months ago. I am in the middle of a flare in my mid back and it is very painful. My right knee also kicked in yesterday and I went to the ER. They gave me anti-inflammatory patches which I don't think helped me much. Lidoderm patches do help a bit, but the spot on my back is hard to get a patch on and stay on, but it's worth a try. I had drug induced ulcers so non-steroidal anti-inflammatories are no good for me.

    I have become pre-diabetic too since diagnosis. I am losing the weight by dieting and walking. Not easy with the pain. But exercise does help. It's important to stay active with mild activity but not to overdo it.

    Docs usually prescribe the DMARD (disease modifying drug like MTX or Arava) first to see your reaction to it, then add the biologics such as injectibles or IV treatments like Humira and Enbrel. But the injections are designed to get you through flare ups.

    Good luck, I hope you find the right "cocktail"
    sewinsnap responded:
    Hi There,

    You don't say how your sleep patterns are..have you ever had a sleep study done? This could be a big help.

    I too fought the Humira suggestion for 5 years, I finnaly started the shots this spring and what difference they made! I would say that you probably have fibromyalsia (sp) also. Do you take an antidepressant? Taking Cymbalta was life changing for is my drug regimen now..Humira, Cymbalta, Nurotin. I DON'T take steriods! BAD! You should get no more that 3 shots of that a year, cause permanet damage after 3. And prednisone...after trying for 3 days I felt very mean...and I'm not a mean person, so down the toliet those pills went! For pain I use Advil and Lidoderm patches. Don't have much pain anymore with the drug program I'm on. Thank God. Hope this helps.
    harry3540 replied to Pretzelady's response:
    I am in a similar situation. I have had great success with an Arava/Mtx combo for 11 years, along with a steroid shot for the occasional flareup. My doctor wants to change my meds due to changes in my RA to Enbrel. The bloodwork is essential, as is a TB test. The side effects of Arava are similar to the "shots" but can be the same at times. To help make up my mind, I got a detailed info packet from the manufacturer and talked to someone who is on the shots. I have experienced the infections and have learned how to deal with them as well as avoiding them and other problems. I have found that the occasional burden of my meds by far outweigh the pain and swelling that I had before I got control of my RA. Talk to your doctor and ask the questions you need to address your concerns. And good luck.
    pat9280 responded:
    hi i'm new to the board. i was diagnosed 5 yrs ago. i worked in a textile mill at the time and had to quit shortly afterwards. i live with pain daily but have learn to deal with it. ijust had ashort of steriods in both my knees about two weeks ago they really helped. when i was still trying to work i took them every 3 to 6 months. i also take mtx with enbrel that i self inject. i was feelig tired a lot so i started taking B12 and a super B complex supplement that made me feel much better now i can do daily chores without giving out. i hope this will help u in some way.
    pat9280 responded:
    Hi i,m new to the community. i was diagnosed 5 yrs ago. i deal with pain daily. i just had shots in both my knees, they feel so much better. i use to work in a textile mill and before i had to quit i had steroids injected every 3 to 6 months. i use to feel tired all the time until i started taking B12 and super B-complex supplements. now i'm able to do my daily chores without feeling drained. i also take mtx with enbrel. pain is part of RA u have to try a lot of things sometimes to find what works for u. good luck; i hope this helps. pat9280
    Pretzelady replied to pat9280's response:
    Thank You to all of you nice people for responding to my call for help. After I finished my weeks supply of steroids, I went back to my rheumy. By this time I felt pretty good, so he decided not to put me on the Humira. He did bloodwork and put me on 2.5mg of steroids a day, which is only one pill. He said it is a real low dose. I still have to take my 3 mtx pills per week. He really wanted to up that dose but I really didn't want to as my hair got thin from it. Right now I feel good and decided not to take the steroids till I start to feel pain. My last bout of pain lasted 6 weeks in my hands, wrists and upper arms. Maybe I will go into a short remission. I am waiting to see what happens. I have to go back to my rheumy in 10 weeks to see how I am doing. If any pain starts, I will immediately start taking the steroids. Hope things are going well for all of you. It sure is nice talking to someone who can relate to what you are going through. Good Luck to all.

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